Meeting NewsPerspective

Thrill-seeking activities relatively safe for hypertrophic cardiomyopathy

Nikolaos Papoutsidakis

CHICAGO — Patients with hypertrophic cardiomyopathy who participate in thrill-seeking activities such as roller coasters and jet skiing after a diagnosis had mild symptoms, although significant events including implantable cardioverter defibrillator shock and syncope were rare, according to data presented at the American Heart Association Scientific Sessions.

“Lifestyle education is an integral part of HCM management, and one question that frequently came up from patients in our institution was whether it was safe to continue thrill-seeking activities they previously enjoyed,” Nikolaos Papoutsidakis, MD, PhD, instructor of cardiology at Yale University School of Medicine, told Cardiology Today. “We realized there are a paucity of data on this topic, so we set up this study to add a discussion point between doctors and their patients.”

Researchers analyzed data from 633 patients (mean age, 51 years; 351 women) with hypertrophic cardiomyopathy.

Patients were invited to the study through an anonymous online survey which collected information on thrill-seeking activity participation and associated symptoms. Thrill-seeking activities were defined as jet skiing, roller coaster riding, bungee jumping, rafting, paragliding, rappelling, motor racing, kayaking and canoeing, snowboarding, skydiving and base jumping.

Of the patients in the study, 556 reported participating in thrill-seeking activities, and 331 patients continued participation after diagnosis.

Patients were at high risk for arrhythmias, with 45% after implantation of an ICD, 24.4% with daily symptoms, 31.4% with a history of ventricular tachycardia and 13.8% after an ICD shock.

The number of thrill-seeking activities undertaken was 7,994, and 33.6% of patients had minor events such as dizziness, nausea, palpitations or chest pain.

Significant events during the activity or with 60 minutes after participation were reported by 0.02% of patients. One ICD shock was also reported during this time.

“For lifestyle changes in HCM, we support a shared decision-making approach,” Papoutsidakis said in an interview. “Physicians can use these data to inform their patients about possible risks — in this case, probably very small risks. Patients can then make a more educated decision about the risks and benefits of participating in the activities they enjoy.” – by Darlene Dobkowski and Erik Swain

Reference:

Papoutsidakis N, et al. Poster Su2110. Presented at: American Heart Association Scientific Sessions; Nov. 10-12, 2018; Chicago.

Disclosures: The authors report no relevant financial disclosures.

 

 

Nikolaos Papoutsidakis

CHICAGO — Patients with hypertrophic cardiomyopathy who participate in thrill-seeking activities such as roller coasters and jet skiing after a diagnosis had mild symptoms, although significant events including implantable cardioverter defibrillator shock and syncope were rare, according to data presented at the American Heart Association Scientific Sessions.

“Lifestyle education is an integral part of HCM management, and one question that frequently came up from patients in our institution was whether it was safe to continue thrill-seeking activities they previously enjoyed,” Nikolaos Papoutsidakis, MD, PhD, instructor of cardiology at Yale University School of Medicine, told Cardiology Today. “We realized there are a paucity of data on this topic, so we set up this study to add a discussion point between doctors and their patients.”

Researchers analyzed data from 633 patients (mean age, 51 years; 351 women) with hypertrophic cardiomyopathy.

Patients were invited to the study through an anonymous online survey which collected information on thrill-seeking activity participation and associated symptoms. Thrill-seeking activities were defined as jet skiing, roller coaster riding, bungee jumping, rafting, paragliding, rappelling, motor racing, kayaking and canoeing, snowboarding, skydiving and base jumping.

Of the patients in the study, 556 reported participating in thrill-seeking activities, and 331 patients continued participation after diagnosis.

Patients were at high risk for arrhythmias, with 45% after implantation of an ICD, 24.4% with daily symptoms, 31.4% with a history of ventricular tachycardia and 13.8% after an ICD shock.

The number of thrill-seeking activities undertaken was 7,994, and 33.6% of patients had minor events such as dizziness, nausea, palpitations or chest pain.

Significant events during the activity or with 60 minutes after participation were reported by 0.02% of patients. One ICD shock was also reported during this time.

“For lifestyle changes in HCM, we support a shared decision-making approach,” Papoutsidakis said in an interview. “Physicians can use these data to inform their patients about possible risks — in this case, probably very small risks. Patients can then make a more educated decision about the risks and benefits of participating in the activities they enjoy.” – by Darlene Dobkowski and Erik Swain

Reference:

Papoutsidakis N, et al. Poster Su2110. Presented at: American Heart Association Scientific Sessions; Nov. 10-12, 2018; Chicago.

Disclosures: The authors report no relevant financial disclosures.

 

 

    Perspective
    Jon R. Resar

    Jon R. Resar

    The study examined the safety of participating in thrill-seeking activities by patients with hypertrophic cardiomyopathy. Although significant adverse events were relatively rare in this population, there were events such as syncope and appropriate ICD firing. Four of the nine events occurred during roller coaster riding.

    Patients with hypertrophic cardiomyopathy should be cautioned about participation in these activities as they are in strenuous physical activity.

    This study is self-reported by response to online surveys and may be subject to selection bias. Further confirmatory studies should be conducted, especially in activities such as roller coaster riding.

    • Jon R. Resar, MD
    • Professor of Medicine
      Division of Cardiology
      Director, Adult Cardiac Catheterization Laboratory
      Director, Interventional Cardiology
      Medical Director, Structural Heart Disease Program
      Johns Hopkins Hospital

    Disclosures: Resar reports no relevant financial disclosures.

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